Patient presented with an external opening at 7 O' clock position with intermittent pus discharge.
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An irregular fistulous tract is seen extending from the skin surface, traversing the external sphincter, into the intersphincteric plane. A secondary 'horse-shoe track' to contralateral side is also seen
According to St. James University Hospital MR classification system, Grade 2 perianal fistula, is intersphincteric fistula with secondary track or abscess formation. Patient was operated, and diagnosis was confirmed.